From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Dermatology Department, Aster DM Healthcare, Dubai, UAE.
Dermatitis. 2024 May-Jun;35(3):246-249. doi: 10.1089/derm.2023.0360. Epub 2024 Jan 23.
Polymorphous light eruption is largely characterized by a delayed-type (type IV) hypersensitivity reaction to 1 or more undefined endogenous ultraviolet-induced skin antigens. To evaluate the efficacy of tofacitinib in refractory cases of polymorphous light eruption. Seven patients who had failed multiple systemic treatments or relapsed within 2 weeks of existing systemic agents with concomitant photoprotection were offered tofacitinib after written consent. Initiation of tofacitinib led to a marked reduction of itching (mean ± SD 3.1 ± 1.12 days) followed by clinical resolution (mean ± SD 2.6 ± 1.1 weeks). The duration of therapy ranged from 1 to 3 months (mean ± SD 2 ± 0.63 months), and 4 of 7 patients had a recurrence in 5.5 weeks and were again initiated on tofacitinib with a prompt response. Tofacitinib inhibits Janus kinase (JAK)1 and JAK3 thus it can abrogate the effects of the predominant cytokine milieu of polymorphic light eruption (PMLE) and thus reduce the expression of aberrant inflammatory T lymphocyte expression in PMLE.
多形性日光疹主要表现为对 1 种或多种未定义的内源性紫外线诱导皮肤抗原的迟发型（IV 型）超敏反应。评估托法替尼在难治性多形性日光疹病例中的疗效。7 名患者在接受书面同意后，在伴有光保护的现有全身药物治疗后 2 周内复发或多次全身治疗失败，接受了托法替尼治疗。托法替尼的起始治疗导致瘙痒明显减轻（平均±SD 3.1±1.12 天），随后临床缓解（平均±SD 2.6±1.1 周）。治疗持续时间从 1 至 3 个月不等（平均±SD 2±0.63 个月），7 名患者中有 4 名在 5.5 周时复发，再次迅速开始使用托法替尼治疗，反应迅速。托法替尼抑制 Janus 激酶（JAK）1 和 JAK3，因此可以消除多形性日光疹（PMLE）的主要细胞因子环境的影响，从而减少 PMLE 中异常炎症性 T 淋巴细胞表达。
